Are you thinking about using donor sperm, egg, or embryo or using a surrogate? We talk about the current trends in third party reproduction with Corey Burke, an embryologist and Tissue Bank Director at Cryos International Sperm & Egg Bank.
In this episode, we cover:
This podcast is produced by www.CreatingaFamily.org. We are a national non-profit with the mission to strengthen and inspire adoptive, foster & kinship parents and the professionals who support them. Creating a Family brings you the following trauma-informed, expert-based content:
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Please leave us a rating or review RateThisPodcast.com/creatingafamily
Are you thinking about using donor sperm, egg, or embryo or using a surrogate? We talk about the current trends in third party reproduction with Corey Burke, an embryologist and Tissue Bank Director at Cryos International Sperm & Egg Bank.
In this episode, we cover:
This podcast is produced by www.CreatingaFamily.org. We are a national non-profit with the mission to strengthen and inspire adoptive, foster & kinship parents and the professionals who support them. Creating a Family brings you the following trauma-informed, expert-based content:
Please leave us a rating or review RateThisPodcast.com/creatingafamily
Please leave us a rating or review RateThisPodcast.com/creatingafamily
Please pardon any errors, this is an automated transcript.
0:00
Welcome, everyone to Creating a Family talk about infertility.
0:03
I'm Dawn Davenport. I am both the host of this show as well as the director of the nonprofit, creating a family.org. Today we're going to be talking about the current trends in third party reproduction. We will be talking with Corey Burke. He is an embryologist and tissue bank director at Cryos International Sperm and Egg Bank. Welcome Corey to Creating a Family.
0:27
Dawn, thank you, it's always a pleasure to be with you.
0:31
Today we're going to we're going to be doing a show that is over an overview of where we stand right now, in third party reproduction. There's been so many advances in the last Well, I was gonna say 10 years, but honestly, five years we've been seeing advances and we've and we've also been seeing a real societal shift towards acceptance of third party reproduction. So for people who are thinking about it now and are trying to figure out is this for me, what are my options? That's what we're covering today. So it would probably help since you and I and the people in the field know what we mean by third party reproduction. But for an average person that is not the term that they use. What do we mean by third party reproduction?
1:19
That's a great question because it really means a lot of things. But basically, it means using someone else's sperm or eggs or embryos that have been donated by another person to achieve pregnancy and an infertile couple that covers everything with sperm donation, egg donation, again, embryo donation, some people have embryos leftover from an IVF cycle. They don't have anything to do with it don't shouldn't say don't have any do with them, but don't want to use them further. And sometimes they'll donate those to a couple who needs them. So there's many, many aspects to third party reproduction. It also includes surrogacy, although the surrogate is not necessarily donating a sperm or egg or embryo. They are donating the vessel to carry the pregnancy. And
2:02
yes, some people don't consider surrogacy as a part of third party reproduction. But I do, because it's all in the same genre. I liked how you said that she is donating. She's donating a uterus. So
2:14
yeah, exactly. And that's, for me my perspective, anybody who's donating something to help in that journey to become pregnant? I think they all fall under third party.
2:22
Yeah, I as well. All right. So let's begin with really the, I guess, the granddaddy of third party reproduction, or certainly what we have been doing for a much longer period of time, and that is sperm donation. So have their what are the current trends in sperm donation right now?
2:42
You know, that's a great question. And like you said, sperm donation has been going on for so long. Yeah, current trends. That's an interesting topic. What's the current trend? Yeah, not a lot changes with sperm, sperm and sperm and sperm. But there are some new things going on. One thing that you you touched on a little bit earlier is the amount of people who are using sperm as ever growing in 1995, about 180,000 Women use donated sperm. By 2017, over half a million women use donated sperm to achieve pregnancies or to attempt to achieve pregnancy. So the growth has been phenomenal. And yeah, what's what's contributed to? That is the big question. That's probably one of the current trends. Yeah,
3:24
that's what I was saying what? Excise? Yeah, acceptance,
3:27
you know, everybody, so So there's a number of things. There's been a lot of movie stars or rock stars or whatever out there that have used sperm or other donated gametes to become pregnant with you know, you have these 50 year old Madonna's or whoever they happen to be getting pregnant, you know, they're not getting pregnant on their own, they're having helped. And I think that's, that's been a big part of the acceptance, you know, that just the spotlight on it, that people do this. It's not uncommon. It's not taboo. It's not a, you know, I don't wanna say it's not a big deal, but it's just not taboo anymore. There's also been a trend towards single women having babies on their own, there's a lot of women out there who, you know, hit hit that ripe old age of 35 or so and say, Lord, you know, I gotta I gotta have my my children now, I can't wait to find Mr. Right. You know, and they're moving on that actually. They're, they're taking that step and using donor sperm to achieve the family they want to have. And, you know, lastly, or not lastly, but one of the primary things that has made a huge impact is the acceptance of gay marriage and, and gay gay couples. And, you know, lesbian couples use a lot of sperm why lesbians don't have sperm I mean, you know, it's a fairly simple thing with with heterosexual couples, you need a partner that doesn't have sperm so it's a whole different issue, but with lesbian couples, they they just simply don't have sperm and they need sperm to have babies. You know, that's the simple birds and bees of the matter. Right. And that's, that's gone a huge, huge way for the acceptance. I think, you know, we had to start Step by step we had to have people society just accept it as not being taboo and And then then single women moving on with that. And then lesbian couples have certainly just driven that over the top. You know, I mean, there's a huge number of lesbian couples who, who use sperm to have babies. So it's a great thing. I'm very happy about that.
5:15
What what do you see as far as the numbers, who percentages, we think in terms and I think incorrectly, obviously, that that is heterosexual couples with a male factor infertility, and that they're using donor sperm? And I think in the past, that probably in the distant past, that probably was the majority of people. So who are you who is using donor sperm
5:39
right now? I mean, again, single women, we have a lot of single women, but our major, major crisis, the major customer, for sperm donation is lesbian couples, you know, again, they are driving the market tremendously. And again, the single single women also as well, but certainly more lesbian couples come to us than any other one fraction of the population.
6:04
And how do they how are they changing the field of sperm donation? How are that singles in the end? Well, predominantly, the lesbian couples, but also the single women? How are they changing? How how we have how we've done sperm donation in the past?
6:20
That's an excellent, excellent question. So I mean, the big thing for this, so when we think about people with male factor infertility, you know, generally they have to go to a physician of some sort, whether it's a family practitioner that does IUI and things, but you know, normally you have to go to reproductive endocrinologist, they need the help, they have to have somebody there to help them. One of the things was single women and lesbian couples, they don't necessarily need the help. Again, like I touched on earlier, lesbians don't have sperm. I mean, it's a simple fact, they don't have sperm, they don't need as much help to get pregnant. So we offer home insemination, you can actually purchase sperm from us and do it, do it, do it yourself. You know, if you think about the process, it's not that difficult to inseminate yourself. You know, people do it every day in nature. And it's not that difficult. And that's one of the major changes that has come about, we have a lot of single women and a lot of lesbian couples, or whatever the situation may be, that don't require the medical help so they don't have to spend 1000s of dollars to go to the doctor and have the have a workup done on and stuff. Now that said, I always recommend that you make sure you're you're healthy enough to become pregnant before you try to become pregnant. But you know, other than that, you probably don't need much help. You know, most people in normal life go through life and they they have sex they become pregnant. And that's just the way it works. And we've kind of made it that way for for the people who don't need the help. Now you can actually purchase sperm from us inseminate yourself at home, it's as as successful as anything else. And it's been a major trend that that I've seen come along in the past. I don't know how long it's been eight years or so 10 years or so that we've been doing home inseminations.
7:59
And it's ever increasing. What is the success rate of home insemination versus inseminating in a doctor's office?
8:08
Well, so far, what we can tell there's not a lot of good studies on this, we're actually trying to see if we can put some stuff together regarding this. But the the average success rate is around 20%. Either if it's done IUI. In a doctor's office or by home insemination, it's slightly less, it might be around 17% For for home insemination, just because it's the insemination is done vaginally, rather than going through the up into the uterus. So it starts out a little slower, but it's really very successful. It's you know, if you think about how often you get pregnant in nature, it kind of mimics those numbers.
8:42
Well, and a heterosexual couple has this as an option, but the difference, they have male infertility, the difference is there already in the medical community in the sense that generally, they have been seeing a reproductive endocrinologist trying to figure out why they aren't going to get pregnant. So they're already in the system? And are you seeing that that heterosexual couples are less likely to use home insemination? Yeah,
9:10
that's a great. That's a good point. I would say yes, they're a little less likely to use it because again, they already are in the system. So they've they've already got on that. On that train, so to speak, they're already there. They're having it done. You know, I think that I think it's a different situation, because usually the male has to be diagnosed as having male factor. And that can be a lot of things. They can either just not have sperm in general, they can have something wrong with their sperm. And you know, if you don't have sperm in general, that that could be a little easier to diagnose that you just have no sperm and you something's there's something impossibly fixed or whatever. But I think that I think you hit on the point right there. I think that they are already in the system, and I think they just generally stay in the system. And again, there's nothing wrong with the system. It's fine. It works well. But I think there are some heterosexual couples that would be good Good candidates for home insemination as well. And I do I do recommend this sometime when we have we do some client storage. So we'll have people going out of town like in the military or something like that they're they're being shipped overseas. And you know, oftentimes when we when we store them, I'll recommend to them that they can do the home insemination themselves and don't have to seek a doctor to do this. Now that said, Doc's, please don't be mad at me. No, I hate it. I'm not trying to steal business from you. I'm just trying to help as many people as we possibly can.
10:29
But they're not going to map an IUI and enter uterine insemination, which as you mentioned, is different primarily in from a home simulation when it's done in a doctor's office. But to it, you know, a catheter is threaded through the cervix into the uterus, and the sperm is deposited there versus depositing the sperm in the vagina where it then travels through up through the cervix into the uterus. That's the that's the major distinction. I don't think doctors are really going to worry about missing a few IUI
11:01
they shouldn't. And you know, most people, exactly, they shouldn't miss too many IUI.
11:05
Yeah, and I don't think that's, that's not where they're making their money anyway. Right, right. I have some exciting news, we have just celebrated our 15th year. That was last week, actually our 15th year of doing this podcast. That means we have 50 years of archive shows. So if you subscribe to this podcast, you have access to 15 years of wonderful interviews with leading experts on topics that are so directly relevant to your infertility journey. So please subscribe to the creating a family podcast. And if you don't know how it's easy to do on whatever app you're using to listen to this podcast, you can search for creating a family and there's a button that says Subscribe. Okay, another change in change that I'm curious about. We have certainly seen in the last 10 years, but certainly even more. So in the last five, three types of years. The stories in the media about anonymous about this as anonymous donors are people finding out about that they were conceived through donor sperm, and having not been told, and the real push from the donor conceived community, that there there should not be anonymous donation, that is analogous to the movement that has been happening for the last 30 some years, maybe even more in adoption, where it used to be closed adoption, and now we're moving to open adoption. Okay, before people get all upset, I am not making a direct correlation between third party reproduction and adoption. However, I do think non genetic parenting has some commonality. So it's worth at least mentioning that that has happened. So where do we stand now? On the whole idea, I'm only speaking of sperm donation at this point of identified versus anonymous donors.
13:05
You know, that's that's a very complex topic. You know, the whole point of when we started sperm donation back in the long, long, long ago, you know, a lot of the donors were medical students, you know, and they would they would get people to donate in medical school. You know, they didn't want to be identified, we probably had anonymity, we couldn't find out who they were, I get, I get the reason that it started. That way, I understand it completely. I think the push now is more towards open identity, meaning that your child can find out when they're 18, or whatever the set age happens to be. And I think that's a great thing. I'm all for open identity, I think that's the best way to go. However, for us, in the sperm business, the world's a big place, and in some countries, believe it or not, known donors are not allowed. They must be anonymous donors. That's just the way it is. So you know, and there are still some people in the US who, you know, right or wrong. And again, this is this is something that's still be debated, I guess, but ethically, you know, heterosexual couples, a lot of times a man, you know, it's a big deal to them to not have sperm, it's, it's, in my opinion, it's a little bit more of an issue than women who have infertility because, you know, you can use an egg donor, you carry a baby with the with, with the donated eggs, you have the baby, it's your baby, you know, from from a male standpoint, if you're using donor sperm, it's not your baby, there's no there's no connection at all. Somebody else got your wife pregnant. So I understand some of the reasons for it. I think we have to come to a solution on this because I don't think it's right to keep the genetic parenthood from it from a donor at all. And I'm all in favor of just having non or non anonymous donors. I think it's the way to go. I think we're a long ways off from getting there. I think the US is a little bit closer than anybody else. Maybe UK or a few places like that, but
14:59
I think they're countries that have actually outlawed anonymous donation.
15:03
There are Yeah, there are both. That's exactly it. There are there are both. And that's kind of the complexities of running a sperm business, right. So you have to keep up with all these regulations, there are countries that just absolutely don't allow known donation. And there are countries that don't allow unknown donations. And you know, in today's world, anybody can have a 23andme, or your your cousin can have a 23andme, or family member, and you will be found, you know, if somebody is looking, you will be found out, yeah, and I think, you know, it's so complex, because back in the day, we used to promise people that they would be anonymous, and you know, their careers and things to think about, and families and things to think about. And, you know, I kind of feel a little bad for those people that we know, I'm not saying we me personally, but we promise would be anonymous. Now today, all of a sudden, it's like, you're not, you know, 23andme just blew that out of the water. And you're, you're there. So you know, it's very complex thing. And I think we still have a long way to go with with working all of this out. But I think we're getting much closer. And I would say in our particular business crisis, just speaking of crisis, we're in the US, we're about 70% of our donors are known donors. And again, that's that's where we like to go. But because we sell to other countries outside of the US as well, we have to keep some anonymous donors coming.
16:21
Yeah, there used to be I mean, I remember that probably mature, maybe over 10 years ago, there was all you would hear about is that if if you require donors to be identified, and keeping in mind, but what we mean by identification is mean that they would depends, of course, on what depends on what the agreement is. But generally speaking, it's that the, that you can transmit medical information, or you can transmit information, and when the child turns 18, or whatever, there's an age that the child then would have the access to this information. So that's what we mean by known. And there was this hue and cry that said, there will be no, all donors will just completely shrink, that will not happen. And that really has not come to pass. Yeah,
17:09
it's it's actually, it's very remarkable, because I like, you know, I've been doing this for a long time. And I've seen that that change, you know, back in the day, we would have people doing IVF that would almost sneak into the practice, you know, that didn't anybody know that they're even doing IVF much less using a sperm or egg donor. And, you know, just in the donors themselves, we have had a trend towards known donation. People want to be known known donors, they, you know, it didn't used to be that way. They all want to be secretive. They didn't want anybody to know about it. But now it's, it's completely reversed. In some senses. Interesting. Yeah. So it's a very interesting situation.
17:45
Yeah. Well, and as you point out, the reality is, there is no such thing as an anonymous donor. And I mean, I think I'm sure that you tell your donors that and your recipients.
17:56
Absolutely, absolutely. And I would would like to touch on one other thing. You know, we just recently Colorado came up with a new law that's requiring donors to be known donors, and to be 21 years of age. You know, I think that's great. I really do. I think that's a great, great law sort of, but at the same time, it concerns me a little bit, because, you know, by doing that they've cut the donor pool down considerably by making it 21 and up, and also taking away the anonymous donation. So you know, there's good and bad, there's, that's why I say I don't think we're quite there yet. I think that the Colorado law has some some merit to it. But at the same time, we know that in the UK many years ago, when they when they changed status, they lost all their donors, you know, so I just think we're not quite there yet. But I think it's a good law that they've passed. Maybe it can be tightened up a little bit, I think that they just, you know, I think there's people thinking they're doing the right thing, without thinking about all the consequences that go along with it. As is often the case and keep in keep in mind, sorry, I'm just sorry to interrupt. But keep in mind, even with anonymous donors, you get all of the information from a sperm bank, you get all of the health information, you get everything except the one thing you don't get is to actually contact them. Okay, so And even with our, with our known donors, you have the you have the option to contact them, whether they contact you back or not is up to them, but you can know who they are and know all about them. But that's that's the major difference, you know, anonymous donors, you still know almost everything you could possibly know about them. You just don't get that that personal contact portion.
19:28
Well, but how do you handle the issue that if somebody what you get from them is what they know at the time? Yes. You know, which, and we or even what they remember or whatever, they're young, and they don't I mean, so what you get is as is a moment in time and you don't get and vice versa because I certainly know situations where recipients have their child has developed a genetic condition and they have reached back out and to the to the sperm bank and said, we have in our Child has this condition it is genetic. And so the sperm bank has actually been able to help the donor by saying you need to be tested for this. So before we move off of sperm donation, where do you get? And has there been a change? And where do you find donors? And not just you? I'm not speaking of have I met in general, the industry in general? And has there been a change in the last X number of years?
20:24
No, absolutely. There has been a change. But one thing I want, let me let me touch on that last little bit, you said, so we do when we when we sell sperm to people or eggs for that matter? You know, one of the part of the contract that we signed with them is that they agree to notify us of any genetic conditions that should arise in their child. And the same is true of donors. So we do track the donors, we do try to contact them annually and make sure that there is no changes. And there is times when things come up, you know, a family history has come up or something genetic pops up that we didn't know about. Sure. So it works both ways, both with the donors and the recipients. So I just want to touch on that a little bit. But right, yes, as far as donors, donors have been very interesting, the last couple of years to the pandemic.
21:04
Oh, man hadn't thought about that. donors have just
21:07
they've gone way, way down, you know, and the the good or bad situation for most sperm banks is the sales of sperm went up tremendously. 100%. Can incredible. And that
21:19
was during the pandemic, right? Yes, exactly. Why why did first of all, before we go back to that, why do you think that the use of sperm increased so much during the pandemic? I've heard I've read that, about that. You know,
21:31
I think there's several reasons. But I think one thing is anytime we have a big event like that, like 911, or something like that, you always see reproduction increase, you know, or World War Two, any of these things, you know, that we've always increased our reproduction during those points, I think it's somewhat human nature to just feel that way and do it. I also think that some people were stuck at home being bored and said, Hey, great time to have a kid, you know, we got a couple of years to figure this thing out. So maybe we'll have a child in the meantime. So, you know, I'd love to see somebody actually do some research on that and see what the what the real reason is. But I do know, like I said, in times of tragedy, or national events like that, you know, we do tend to increase the numbers of production that we have going on.
22:14
Well, I wonder, too, if they, and this is, this is all speculation, I just curious if you've heard about this, that people were home and working from home, and all of a sudden that of course, it is a total myth to think that you can work at home without childcare. That just if anybody's listening, let me tell you, that is a myth. You have to it's you can't get anything done with kids. You know, workwise although with if both parents are working at home, you know, working shifts, doing working shifts, you know, where one takes the morning when takes the afternoon. So for some people, I wondered if, you know, you know, we can't afford child care, but you know, if you'll take the morning until 12, and I'll take 12 to six, that type of thing. And we both get up at you know, whatever we work in the evening. I wonder if that had something to do with it.
23:01
I wouldn't be surprised. Like I said, I'd love to see me to something, something concrete about it. See, see what we can find out?
23:08
Yeah, I would like yeah, okay, so researchers out there, Cory and I are curious. And so our listeners, all right, now going back to where you're getting so so that the pandemic one that does make sense, although it wasn't because people didn't want to come in.
23:25
I think that's, that's, for me, that's, I think the biggest thing you know, I, even myself, knowing as much as I know about it, you know, I was I was very paranoid about going to the doctor's office, right? Who wants to go to a doctor's office to sit with a bunch of people who are breathing on them? Yeah, you know, where all this stuff and you know, wearing a mask to the sperm bank and all you know, it just isn't a it isn't conducive to producing sperm, right? I mean, it's just, it's just not the place you want to be in want to do that. And I think that's the big thing. You know, and also for us, you know, not to make there's no secret about it, we, we try to locate ourselves near universities, because that's our target audience, right? educated young men who who can provide sperm for us, the university shut down, and we're all doing online learning. So, you know, all of our all of our University of Central Florida students were gone, there was nobody on campus, all the people in Raleigh were gone every every place that were located at Gainesville, nobody was there. And you know, that took a huge impact on us that just that just really, really took its toll on an all sperm banks, not just us, we all do the same thing. You know, so I think that was a huge, huge thing of it. And again, just people not wanting to congregate in and again, I shouldn't say it this way. I know it probably sounds weird, but I think a lot of people think the same thing. Of all the places you probably don't want to be as a medical office, right? I mean, you got sick people there and it's a good place to get sick. So,
24:49
but not not, but when people are donating sperm, they're gotten and going into a doctor's office.
24:53
Sure. It seems I mean, it's like that but it is it is fairly, you notice somewhat like a medical press It very much is like a medical practice. We try to make it that way. We don't want to make it too, too sleazy, if you will, we wanted to be more of a medical practice, we want people to feel like they're going in and doing what they need to do. Of course, the cabins are, are nice they have they have videos and all that sort of stuff. But, you know, it is still kind of like going into medical practice with a bunch of people wearing lab coats and working in the lab and that sort of thing. Yeah, blood is being drawn. And, you know, basically, it's like going to the doctor's office. So I think that was a huge, huge portion of it as well. Have you seen
25:27
it bounce back? Now that they whether or not we say the pandemic is over? I wasn't going to say that even though President has, but whether but since life is beginning to return to normal and, and IE universities are now back in Perth, yes.
25:42
Yes, that and that made a huge change. You know, being that we're mainly located in Florida, of course, we've been open all along. So it's it's come back greatly. Since the start. We're back to our normal numbers. Now. We were we were like I said, we're desperately low, a year and a half ago, but the numbers are, are coming back rapidly. Definitely with sperm or egg donors haven't come back quite as much as our as our sperm donors have, but they're coming back as well. And you know, one other thing I'd like to touch on the whole pandemic thing as well. You know, the gray market. I've talked with you about this, I think before the gray market is what we call the Craigslist or Facebook, sperm donors that are out there. And I know that during the pandemic that increased and I don't know why exactly, I think just the the desire to get pregnant, in general increased. But, you know, this, this is a trend that really worries me in sperm donation, because with sperm banks, we take about two to 4% of all the people who apply to us. And the reason we take that is because of the stringent screening that we do, you know, all of our donors are screened for medical and family history, infectious disease, genetic karyotype, psychological evaluation, criminal, criminal backgrounds, education levels, all of these things, and we come down to about two to 4% of everyone who applies to us, is acceptable for us to take. And the reason is, they, they all come with some sort of risk. And we try to minimize that risk at sperm banks. You know, we're doing all of this testing, you know, and we have these people out here selling their sperm on. Again, I'm using Craigslist, which dates myself, I don't know that Craigslist even exists anymore, but Facebook or Instagram, or whatever they happen to be using these days, and you don't know anything about them. They're not straining themselves. You know, I wouldn't say that nobody is. But the vast majority of them are not straining their selves, they're just donating sperm. And I'm not sure what the value is to people buying this sperm, I don't see what I know that some of them give it away. But you know, it's not that expensive to buy sperm in the first place. And I just don't understand why you'd want to take that risk. You know, we do a family background check on people, we know people that if they have heart disease in their family, if they have cancer in their family, if their grandmother had had breast cancer, you know, we look into that and see if it's something that's passed on to the to the children that are the donors. So we do so much screening, it's just it's maddening to me to think that there are people out there selling their sperm online, with absolutely no testing. And I will just point out one last thing with this. We actually had a had somebody contact me about a year ago or a little more, and said, You know, I'm thinking about buying sperm from this donor. He says he used to be a donor for you. Can you tell me anything about I mean, first of all, I'm like, well, he's not our donor. So why would I want to tell you about somebody that you're buying offline, but if I guess they sent me a record that we send out with, with each time we sell the sperm, we send out what's called a summary of records. And that tells all the testing that you've had done. So all the infectious disease, all the genetics, everything that you've had done, and she says, Well, here's your here's your donor, he sent me this. And I'm like, No, that's not who this is. And that's not the person you're talking to. So the person was using something he had stole from us, and selling it as himself saying that he was perfectly healthy. He had been tested with all this stuff. And it just wasn't the case. So it's a very scary situation. And I really caution anybody who's out there thinking of of looking at online sperm donors that are not coming from a sperm bank, whether it's us or any other legitimate sperm bank, please, please, please be very cautious in that.
29:19
Okay. Yeah. I hadn't thought about that as being a trend, quite frankly, I did not realize that hidden increase. I mean, it's always been around. But yeah, it
29:27
definitely increased during the COVID period, because and I think it was for two reasons. I think one, there were just a bunch of people that wanted to get pregnant. We saw the increase in the banks, you know, we had tremendous sales. And I think that some people just couldn't find what they wanted. Because as as everybody's sales started to increase, our donor numbers went down. So you know, some people just took that route and thought that was the easiest way to go.
29:51
Hey, let me pause for a minute to tell you about children's house International. They're one of our partners. They are a adoption agency in some Have you have heard about them in the past, so international adoption However, they also provide consulting for international surrogacy, which is relevant to the topic of this show. They can help you untangle the confusing aspects of international surrogacy. And of course, they also have an international adoption program working with 14. Alright, moving on to egg donation, the primary reason but certainly the primary medical reason that people have been using were not well, the two main reasons the primary medical reason for using egg donation is a woman having not enough her egg reserve is low, or for some reason, she does not have eggs of the quality that can be that can be fertilized. Or then we also have the LGBTQ community that gay, gay men. So those are our primary users of egg donation. What are some of the current trends?
31:03
Well, again, you hit it right on the right on the head. Again, I think acceptance has gone up greatly with egg donors. And I touched on a little bit earlier to was saying, you know, if you if you're using an egg donor, I think that as a woman, I don't see how you can not feel that it's your own baby, right? You carry it for nine months, everything. Everything else is natural, except your eggs. And again, we've seen a decrease in applicants since COVID. came around, it's starting to come back a little bit. But you know, the the decrease in egg donors, and I'm not sure exactly why maybe it's more of a medical process. Well, there's more of a medical Yes, maybe maybe the the reluctance for people to come back. You know, because you have to go through a lot of treatments, you have to have exams, you have to have a retrieval, you have to have medications,
31:45
you're giving yourself shots you're in it's you're putting a lot of hormones in your body. I mean, it's a deal.
31:50
Exactly, exactly. So anyway, we are seeing a decrease in numbers. I'm not sure exactly why. But it also seems to be the case worldwide, because we're you know, I'm in touch with we have egg banks in Europe as well. And every place that I go to, and everybody that I talked to is seeing the same, same decrease in donors, and it may just take a little longer to get them back in the door. I don't know what it is, you know, I hope they do because we really, really need them, you know, you know what a gift it is for people to be an egg donor or sperm donor. You know, it's just just tremendous thing. And we really, really need to get our egg donors back. And we're doing everything we can to try and bring it back in the door. But there still seems to be a little bit of reluctance there.
32:28
Interesting. Where do you recruit egg donors from?
32:31
Basically the same place as sperm donors, we do a lot of social media advertising, we hit the campuses that were located near there just do a lot of focused marketing on that age group. So you know, I guess one of the biggest trends I would say, right now with the egg donation is the move towards vitrified. Eggs versus fresh eggs. That's a big 2018, we actually surpassed the number of fresh cycles versus frozen cycles. So frozen cycles past the fresh cycles in 2018. And that's really a big deal. Because there's so much convenience and cost factor related with using vitrified eggs. That it's just, it's, it's been great. You know, every year it's growing more and more, we're seeing fresh donation kind of really tank down. And believe me, I am also a big fan of fresh donation. I've done that for many, many, many years. You know, one of my favorite things to do, it's almost you know, it's it's for me, it's a great thing, but the vitrified eggs have just been such a phenomenal thing for us.
33:31
What's created the whole idea of an egg bank? I mean, there wasn't a banking before.
33:36
No, not really not at all. And you just get that's another you hit on so many good points on it's just it's perfect. You know, one of the one of the things that has been an issue people have been debating back and forth to frozen eggs work is good as fresh eggs. And you know, now it's getting to the point where they are very, very similar. There's four or 5% pregnancy difference between the two. But I argue all the time, the reason that the pregnancy rates are different between the two is up until five years or so ago, embryologist, we're not very good at warming and culturing frozen eggs. Okay, and I say this an embryologist. I don't mean any offense to any embryologist out there. Yes, we're really good at it. We were used to warming embryos, embryos are a number of cells, you know, anywhere from eight to 70 cells. And if you kill a few cells, when you're warming those, it's okay. Most of them live, they survive couple hours later, they're perfectly fine. You know, an egg is a single cell. If you don't warm it properly, you don't treat it properly, it dies and it doesn't do anything. And there was that learning curve that went on. So when we started our egg bank back in 2015 You know, we had to train everybody who was warming eggs for us and you know, I can tell you I go to a lot of labs. Oh, we will remember it was all the time it's no problem. You know, we're great at this. We're fantastic. I'm like no, no, no, not quite like that. We have to step back a little bit. think what this is, and think how we're doing this, you know, and now I'd say over the past two or three years, the learning curve has really decreased so they've they've they've hit that learning curve they've they've come to most labs are now experts at fine are warming their eggs and warming is just such a big picture it's it's vitrification is difficult to, to do anyway, but it's not that difficult. Warming is, in my opinion, the more critical step and verifying eggs you have to if you can't warm the egg, you know it doesn't live it's just it doesn't work. And it used to be when we started doing this many years ago, you know we had so with a with a egg survival guarantee we were guaranteed you'd have this many eggs survive out of a batch. But my point with that was always what survival? Is it just because the egg swells back up and looks like a normal egg did that egg survive? Well, probably not, you know, because we know that a lot of them don't fertilize if they don't fertilize to me, they probably didn't survive anyway. But anyway, I guess the long and short of that is we do have much better labs these days, not much, but not much better labs, much better embryologist in the labs that actually know how to work with eggs these days. And you know, I've got people that we've got a clinic in the Chicago area that actually they buy two eggs at a time from us two eggs at a time. And they are very successful with it. And it's just incredible. Because we guarantee our eggs, if you buy six, we guarantee that you get one blastocyst out of the batch, which means one good transferable embryo at the end of the cycle. Most people get more, but we guarantee that, but this this particular lab in Chicago, just fantastic. They buy two eggs at a time, and they have a high pregnancy rate. And think about how good that is for the clients. You know, if you're only having to pay for two eggs, and your IVF cycle, it's much more affordable for people who are doing IVF with donor eggs, you know, the cost of donor eggs, buying a cohort of eggs is $20,000 or more. If you can buy just two of those eggs, it cuts your cost down considerably. And it's very nice. I don't necessarily recommend using two eggs at just any clinic if they're very good at it's one thing, but you know, I still recommend that you purchase six to eight eggs, I think it's a better, better way to go. Because IVF is always a game of attrition, we start with a certain number and we end up with a certain number. And you know, usually starting with a higher number equals a higher chance of success.
37:27
I remember quite a few years ago, you and I were talking at the American Society of Reproductive Medicine conference and I said something about it. You know, it's so hard to freeze eggs and this is just become no longer experimental. We've had been deemed in you and I were talking and I said I it's so hard because it's mostly water. And you know, we have to worry about that and you went up. No freezing or vitrification isn't the problem, Don, it's the following. And yes, it is. I still remember that when you do this day, you're gonna say vitrification is not the problem. We can do that. But Darn, it's hard to thaw those things. You're not Yeah. So hence the which I think people don't don't actually realize. So that has been the advent of banking, which of course, is because we are now able to successfully freeze and thaw has been just a huge shift. It's been it's been so interesting. It seems to me another shift that we're we're certainly seeing more of and that is autologous egg donation. I think that's what I said that correctly. But anyway, freezing your own eggs for future use. Are you seeing an increase in that? Not just for you, but I mean, nationwide?
38:45
Well, that's that's interesting, as well, because I do see it nationwide. I see a increase in it nationwide. But I think that it's very interesting that some areas do a lot more of it than other places. New York, Chicago, a lot of California. Huge they do they do a tremendous amount of self are freezing for the patient. Florida, Alabama, Georgia, Arizona, not so much. It's very interesting. And I don't know it's interesting. It could be socio economic, economic situation. Maybe there's more advertising to I think, yeah, advertising more more money to go, you know, I don't know social economics could be in the big city areas. It seems to go much better. Now. You know, we're located in Orlando. Orlando is a pretty big city with a very young population and, and good income, but we don't see a ton of it in in the Orlando area.
39:39
Yeah, I think it's the both coasts north on both coasts, the northeast and California. It's certainly probably Chicago although i That's anecdotal. I don't know that but I yeah, I think I think you've hit the nail on the head. I think that's social, economic. I also think it's both advertising but also, what you see your friends doing and what you're what The Zeitgeist What's your hearing, you know, just through the grapevine, and I think that well, and it's also in, we certainly know that some of the tech companies in California, were very, very publicly paying for egg freezing. So I think that also makes a huge difference. That makes
40:21
that makes a huge difference when when Google or Disney or somebody like that is paying that paying the bills, it makes it much more achievable, and something that people take advantage of.
40:31
Sure. Although that is still the vast, vast minority, not the majority. Yeah, yes. All right. You know, I do think there is still a great deal of secrecy associated with egg donation. And I think that, as you pointed out, when you see a 45 year old celebrity or anyone get pregnant with and get pregnant with twins, or the chances are very good, overwhelmingly good that they use donor eggs, and yet, and it's not in any of our business. And I totally respect that it is the child's information and that we don't, they don't owe it to anyone to share this information. But I do think we still suffer from the misconception that a woman's fertility can last into until her early to mid 40s. Yes.
41:23
Great. Yeah. It would be so nice. You know, I agree with your daughter. I don't I don't, there's no reason they have to say yes. But, you know, I think it goes a long way for the ones who do and you know, there have been a number of people who who've become pregnant with donor eggs, or whatever it is. And they have made made an issue of it, you know, said I did this and I think that's so great. It just helps other people so much, you know, if they see, see a celebrity or whatever doing it, you know, and somebody has been wanting to have a child forever. And they say, I can't do this. And, you know, they see somebody 45 or older having it and being done and it kind of gives them hope. And I really do appreciate it when people do actually come out and say I used an egg donor. Yeah, not just let everybody guess that you have. I'm Superman. I was able to get pregnant on my own, even though I'm much too old to get pregnant.
42:09
Yeah, yeah. Yeah, exactly. We would like to pause here to thank our partner Reproductive Medicine Associates of work. They are a full service Fertility Center specializing in vitro fertilization, of course, however, they also do egg donation, egg and embryo freezing, LGBTQ plus family building, reproductive surgeries, as well as male reproductive medicine. They have highly individualized patient care, and they offer it through 13, reproductive endocrinologist and fertility specialist to also have a neurologist and a full service support team. All right, now let's talk about embryo donation. And that is where you would have an embryo almost always, not always, but most often leftover after a IVF cycle or cycles, the couple who created the embryos no longer wants to have more children. So they have access to embryos, they have a number of options, although quite frankly, their options are not that great. We used to be able to donate two research that really isn't much of an option. Now, they could do it and destroy the embryos. Or they can donate to another couple for them to use for hopefully creating their family. So that would be that would that last part would be embryo donation. Anything you're seeing I you know, you don't hear much about embryo donation. So I'm going to ask about current trends. But I you know, why don't we hear? Let me start by saying, or maybe it's just you would think I will, because I'm absolutely fascinated by embryo donation. But I'm not hearing much about it. I have all people probably would.
43:55
Well, that's a great point. And I you would think I would as well, you know, I used for embryo donation International, that credit suite and I started back in Fort Myers, yes, years and years and years years ago. And, you know, I asked that question all the time. Why do we not hear more? Yeah, I know that, you know, I'm not as regularly in touch with with Dr. suite as much anymore, but I do know that they do have a fair amount of embryo donation business going on. You know, it's such a perfect scenario. For me, I think you've got embryos leftover and this goes back to the fresh versus Frozen egg donors to especially so back in the day when we do fresh donations, you know, you get all the eggs from the fresh donor, you might end up with 2030 eggs that might make 20 embryos, okay, you get pregnant off of one or two, you know, one, maybe you have a second child and you have 10 1214 embryos sitting around that are just sitting in a tank. And then you went through the options you can donate in research, you can destroy them. You can do all these things, but you know, especially with donor eggs, somebody donated eggs to you to help you have children, it just seems to me like we'd be getting more people to want to donate their embryos following that, sadly, if I remember correctly, don't quote me on the on the percentages, but it's only about 2% of the people with with leftover embryos that will actually donate to embryo donation versus other options. You'd be, you'd be shocked at how many people just hold on to their embryos. Yeah, I buy Hold on, I mean, 20 years, you know, they're still holding on to him, they're gonna pay for him until the day they die. And then they'll let their children deal with them. You know, so I just, I don't get it, I don't get it. Sort of, but at the same time, you know, it's kind of like giving your child up for adoption. If you've got these embryos sitting in a freezer somewhere, you've got children running around that come from those embryos. So making that choice to say, Okay, I'll give these embryos to somebody else has got to be a really traumatic thing to go through, you know, it's just like giving your child up for adoption, in a sense. So I'd like to see more of it, I really would, I think you'll see more of a push in the in the future. I know that for years when we started this. I remember when we started EDI, but it was it's been a long, long time ago. But at the at that point in time, there was approximately 400 to 500,000, frozen abandon embryos in the United States. So these are these are embryos that people have just stopped paying for. They've just disappeared. Yeah, they're just gone. And the problem with that is no practice wants to destroy an embryo without the owner's the parents permission, right? So everyone sits on them, because we're all scared that if we destroy these embryos, even though we got a contract that says, if you don't pay for these, you can destroy these, and it can go years and years and years. And people still don't destroy them. Because they know that as soon as we do, somebody's gonna call up and go, Hey, I want my embryos. Yep. And that's going to create a giant mess. So it's so yeah, it's just a huge situation that I would love to see a change come about, I would love to see more happen. I think with EDI, I think that the problem becomes that they probably don't have the resources to become bigger than they are. There are some other ones snowflakes and other ones like that, that they're pretty big. But a lot of theirs is religious based. And that nothing wrong with that, just that that's what they particularly are and actually is one of the reasons we started EDI, we found that certain certain groups were not able to get embryos from them. And then EDI was created to be something that anybody can donate, anybody can receive. So there are some good programs out there. And I suggest anybody who has an embryo that wants to make, don't let it go to waste, right? I mean, just just don't let it sit in a freezer, don't destroy it. If you can make that decision and you're happy with it. Just look up an embryo donation place a lot of practices except embryos versus going to session. So if you have your own if you're going to your own doctor, chances are they may have they may do it themselves, they may accept your embryos for donation. You know, whatever service you use, you know, you've gone through all that pain and effort of creating that embryo. The embryologist has gone through a lot of pain and effort to create that embryo, the physicians gone through a lot of make use of it don't don't let it go to waste.
48:19
I will say that creating a family has a number of resources for helping people make this decision. It is often an amazingly difficult decision. And there are two basic models, there is the medical model where you can donate to there are a couple of organizations embryo donation international core you have mentioned but there's also the National embryo Donation Center, which also follows the medical model. And as you pointed out, many clinics have their own internal egg donor I mean embryo donation program for embryos that they have created. So those that's the medical model. And then there was the this the Adoption Model. And there are a number of organizations you mentioned snowflakes, which is nightlight adoptions, there are others who use a Adoption Model and so there are if you're looking to either donate or to be to receive and then there is also self matching, which happens on various sites on the Internet. So so there are options. It's I would have predicted it would have grown and I would have been wrong.
49:28
I both Yeah, there you go.
49:31
I just want to say thank you to cryo international sperm and egg bank both for having Corey be here as our guests but also for their long term support of this podcast. Price is dedicated to providing a wide selection of high quality, extensively screened frozen donor sperm and eggs from all races, ethnicities and phenotypes. And they do it for both home insemination as well as fertility treatment. We've talked about that some Mobile will be in the show. Privacy International is the world's largest sperm bank and the first freestanding independent egg bank in the United States helped me to provide the gift of family. So now let's move to our last third, third party reproduction option and that is surrogacy. And boy, howdy, are we ever seeing a surge in the media coverage of this? No doubt the Kardashians have helped. Like, I don't even know I'm sure they're people are just rolling their eyes now, because I'm not going to be able to say, but at least to the Kardashians, and please don't send me emails, I realize there may be more. But nonetheless, have and that so many celebrities, it seems have had people in the news, I should say, have had children through surrogacy. So it really seems, are we seeing? Or are we seeing an increase in numbers? Are we just seeing an increase in the publicity surrounding or the people who are doing it are the ones who are getting all the publicity? Because they're celebrities to begin with?
50:59
Well, I think the jury's out on that one, to be honest with you, I don't know if we're seeing an increase in actual numbers. With a little caveat there. So we are seeing some increase in numbers, but I'm not so sure. I think we're seeing just more of a publicity portion of it. But that's okay. Right. Because, as I spoke with before, with sperm donors, and egg donors, you know, until you get that publicity rolling it, the acceptance gets a little bit more difficult to deal with. So as we get more out there and knowing that people are doing this than the acceptance becomes greater true, you know, the big trend that I'm seeing, and this is just particularly me, we're seeing a lot of cross border, reproductive care, meaning a lot of people come to other's countries for surrogacy, and I think that's, that's one of the big issues we have to deal with at this point in time is there are places that don't allow surrogacy and even people are doing cross border care, may or may not be able to return home with their child from from a surrogate. You know, you've certainly seen stories about I don't want to say, using NDI I'm not sure if that's exactly the country I would like to point out, but you know, where they weren't able to accept the child in Australia or something because they were born in India to surrogate and that's just a just a fabricated situation. Maybe it did happen, I don't know. But just giving us an example. And also, especially a lot of homosexual couples are using surrogates, just like I spoke about with the with the egg donor or the sperm donors, lesbians don't have sperm. Well, guess what? homosexual couples don't have uteruses. So, you know, it's hard to carry a baby. So that's one of the big ones that we are seeing increase is a homosexual population doing surrogacy because, again, they have to have somebody to carry the baby. It wasn't allowed that many years ago, you know, when it was not legal to do except in certain states. But now it's pretty well accepted across most of the United States. And I'm not sure if it's accepted in every state that may not I don't know that for a fact. But I think that's where every state
52:54
has different laws, and they have exactly and then the laws often depend on whether you're allowed to reimburse a surrogate surrogacy is not cheap, and, and not nor should it be in that sense, what you're asking a woman to do, although not all the money obviously goes to the surrogate. But you also have to go through an IVF procedure. It is involved gay couples are certainly have certainly in the past been one of the top users of surrogates. And I should point out that you talked about us couples going abroad, which is absolutely and and but we also have to acknowledge that there are a lot of people from other countries that come to the US absolutely for surrogates. So it talks about cross border it,
53:40
it goes both ways. Oh, definitely goes both ways.
53:43
I do think judges from a trend standpoint, I would say that one thing that I do hear more of, let's say, in the last five years, maybe even a little longer is a recognition of the Human Rights involved, especially in cert using surrogates in other countries. And I do hear people being more concerned about the fact that if they are thinking about going abroad for a surrogate being concerned about the living conditions, and as reimbursement and the the ethical, which is only a good thing
54:17
is absolutely 100% All right, well,
54:20
anything else that you want to say about current trends and things that people should consider? I'll give you the last word to talk about third party reproduction. Well, I
54:31
don't really have any more current trends to add, but I will say look, you know, anybody out there listening that wants to be a donor particularly that's that's we need donors desperately to reach our goals to have people achieve pregnancies, we need donors, you know, we have to have donors donors are the first line. You know, it's just such an incredible gift that they gave us. So you know, I just want to see third party continue. I want to see our donor numbers go up to provide the best select addition to the people out there who need to need to use to gametes.
55:03
Yeah. And for people who are, are wanting to consider using them, just know that you are absolutely not alone. And a lot of people are doing it and they have beautiful children as a result, so you're not alone. Thank you so much, Cory Burke, for being with us today to talk about current trends in third party reproduction.
55:24
Thank you very much for having me. Always a pleasure.
Transcribed by https://otter.ai